Healthcare Provider Details

I. General information

NPI: 1215177506
Provider Name (Legal Business Name): KIDS-N-MOTION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 NORTHLAND DR NE
ATLANTA GA
30342-2008
US

IV. Provider business mailing address

110 INLAND DR NE
ATLANTA GA
30342-2060
US

V. Phone/Fax

Practice location:
  • Phone: 404-353-6249
  • Fax:
Mailing address:
  • Phone: 404-843-1102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT003731
License Number StateGA

VIII. Authorized Official

Name: MRS. DVORA ZIBITT
Title or Position: DIRECTOR/PRESIDENT
Credential: MS, MPH, OTR/L
Phone: 404-843-1102